Individual
MRS. CAROL ANN STACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
292 BLUE MOUNTAIN RD, SAUGERTIES, NY 12477-3554
(845) 802-6097
Mailing address
292 BLUE MOUNTAIN RD, SAUGERTIES, NY 12477-3554
(845) 802-6097
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
028816-1
NY
Other
Enumeration date
04/21/2016
Last updated
04/21/2016
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